A Leydig cell tumor of the testis is an uncommon testicular neoplasm. Its imaging appearance on ultrasound and MRI is nonspecific, but clinically it is associated with serum hormonal imbalance.
1-3% of all testicular tumors, but the most common sex-cord stromal tumor. Tend to be bimodal, with one peak occurring in pediatric patients (5-10 years) and one in adults (20-30 years). Malignancy occurs in ~10% of tumors.
Leydig cell tumors arise from the interstitial cells of Leydig adjacent to the seminiferous tubules.
Leydig cell tumors of the testis may present with serum hormonal imbalance (~30%). Virilization (including precocious puberty) may occur. Hyperestrogenism may also occur and patients may demonstrate gynecomastia.
Malignancy cannot be excluded on imaging.
- small, hypoechoic, round intratesticular mass
- may demonstrate cystic areas
- most often unilateral
- difficult to differentiate from other testicular tumors
On an imaging differential, consider:
- 1. Woodward PJ, Sohaey R, O'Donoghue MJ et-al. From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation. Radiographics. 2002;22 (1): 189-216. doi:10.1148/radiographics.22.1.g02ja14189 - Pubmed citation
- 2. Kim I, Young RH, Scully RE. Leydig cell tumors of the testis. A clinicopathological analysis of 40 cases and review of the literature. Am. J. Surg. Pathol. 1985;9 (3): 177-92. Pubmed citation
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